What is a trichologist?

When it comes to hair loss, most people can feel very self-conscious. It’s not something that is easy to talk about, although it affects both men and women and it is remarkably common. People who lose their hair can often see their self-esteem and confidence affected dramatically.

The question is, where do you turn for help? Visiting your GP is an option, but many GPs do not necessarily view hair loss as a serious condition and do not give patients the time they need. The issue is that, while hair loss may be the cause of the visit to the doctor and the problem that needs to be treated, there is really that GPs need to be more adept at dealing with. How do they deal with your loss of self-esteem? How do they deal with the fact that other aspects of your social or working life are suffering?

GPs with a full waiting room of coughing patients do not always have the time to discuss the issues around hair loss and its treatment fully. One option that is available to people is to visit a Trichologist. If you haven’t heard of Trichology, you aren’t alone. But don’t worry – you’re in exactly the right place to find out more.

Ok. So tell me more?
Let’s start with what Trichology actually is. A qualified Trichologist is a specialist in scalp and hair problems. So as well as hair loss, this can include itchness of the scalp, dryness, oiliness, scaling of the scalp. In technical terms, you are probably talking about a list of conditions that includes things like alopecia, male-pattern baldness, as well as different forms of psoriasis dermatitis and eczema.

Trichology is not a medical discipline and most practitioners work from home or in high-street locations in a similar way to physiotherapists, acupuncturists , chiropodists and practitioners of alternative therapies, such as reiki. Most practitioners of Trichology build up their client base over time, working with individuals to maintain healthy hair and a healthy scalp.

So can anyone do it?
Anyone can train as a Trichologist but it takes time and learning to become good. Trichology gets its name from the Greek word ‘trikhos’, which means hair, and was first practiced in England in 1902. So it is a profession with over a century of knowledge, insight and expertise to build on.

If you are looking for a Trichologist, ideally, you should find one that comes with a recommendation. At the very least, you should choose a Trichologist with a recognised qualification from the Institute of Trichology. This programme has been running since 1908 and the syllabus is comprehensive, covering everything from scalp physiology, anatomy and chemistry to hair microscopy, nutrition, maladies and treatments. Pretty much everything known on the subject, from follicle to tip.

Once an individual has qualified as a Trichologist, they must practice in accordance with a code of conduct, ethics and principles outlined by the Institute of Trichology.

So what exactly does a Trichologist do, then? 
The first thing to remember is that they are not miracle workers. So – as we’ve emphasised elsewhere on this site – if you have male-pattern baldness, that is part of your genetic make-up and there is not cure for it.

However, it is important to remember that the health of your hair can be a good indicator as to the quality of your general health and the healthiness of your lifestyle. If you have male-pattern baldness, it could be that a trichologist could help to slow the rate of hair loss by considering factors such as scalp nutrition and medication. It could even be that lifestyle issues such as stress or anxiety are contributing to your hair loss.

Getting the right diagnosis is therefore essential before you begin any course of treatment. A specialist trichologist can often provide a much more detailed hair diagnosis than someone like your GP, for example.

Most Trichologists will be able to diagnose the healthiness of your hair in a number of ways. They may perform a microscopic analysis, so that they can assess whether your hair loss is caused by genetic factors or caused by something that can be directly treated, such as a fungal infection.

Secondly, they may perform a blood analysis so that they can evaluate how effectively you body is transferring minerals to your hair and scalp. At any given time, the hair follicles can contain a variety of minerals including magnesium, calcium, mercury and arsenic, as well as others such as copper, chromium, lead, aluminium, zinc and copper. The different levels of minerals in the hair follicles can adversely affect how well the hair grows.

The aim of the diagnosis will ultimately be to establish the answers to a number of vital questions:

Is your hair loss greater than would be expected?
Has the hair suffered any structural damage?
Is the scalp in good condition?
Are there genetic factors involved?
Is there any disease, fungus or lice present?
What kind of treatment can I expect?

If you find a good Trichologist, you can expect more than a five minute glance at your head. Most Trichologists understand that treating hair loss is as much about understanding the person and how they feel, as it is about a medical diagnosis. As well as blood tests and microscopic analysis, most Trichologists will also spend times getting to know you, how you feel about your hair loss and what expectations you have. They will also investigate how you feel about different types of treatment and try to ascertain what approach will be right for you.

Once your Trichologist knows more about you and your condition, they will normally choose between three courses of action:

Can they recommend treatment for your problem?
Do they need to refer you to a doctor?
Is a surgical procedure the best option?

With male-pattern baldness, most trichologists will discuss with you the merits of appropriate medical treatments as opposed to other procedures such as surgical transplants or non-surgical hair replacement. You can find out more about different treatments elsewhere on this site.

For many people, one of the greatest benefits of visiting a trichologist is that they can offer a broad overview of the treatments available. Unlike a GP, they are not restricted to medical procedures. Many trichologists will maintain an overview of different types of natural alternatives, therapies or herbal remedies. Their independence gives them the scope to recommend the right treatment for you.

Summary
Many people find that a Trichologist can provide invaluable help, support and expertise when treating their condition. In many cases, however, the key is their individual relationship with their Trichologist. A good practitioner will take time to get to know you, so that even if they cannot help your male-pattern baldness significantly, they can provide treatment and advice that goes some way to rebuilding your self-confidence.

In many ways, it is because this relationship is so different to the relationship with a GP that people find it so rewarding. It gives them a much better environment in which to discuss their hair loss and to identify the treatment that is right for you.

Do you have Hair Loss Problems, read our Hair Loss Help

What Are Medicated Shampoos?

These deserve a particular mention as generally they are used far too widely and indiscriminately. They fall into three categories.

Firstly tar shampoos, which can be made from varying fractions of either coal tars or wood tars. There is some concern that the long term use of coal tar shampoos can be carcinogenic. Tar shampoos are usually helpful in the treatment of dry, scaly or itching conditions of the scalp and may be used preferably as short term measures in helping to treat simple scurf or dry dandruff, psoriasis and certain types of neurological eczema. Tars are not easily soluble however and some of the bases for these may be too drying for the scalp. Also, the main objection to their use is the smell. Wood tars are usually therapeutically more efficient and have aromatic smells less reminiscent of the road-menders tars than coal tar.

Modern dandruff shampoos contain as active ingredients either selenium sulphide which is a chemical irritant and poison or zinc or zirconium pyrithione or omadine salts. As these all tend to have an irritant action on the scalp, they may cause a greater production of scalp oil making the hair become oily more rapidly. This is rarely stated on the label. They are better used with caution and it is never a good practice to use any medicated compounds on the scalp over a long period without good reason and certainly not as a palliative to prevent problems.

Hair and skin cleansers such as cetrimide can be very useful as they are often very efficient skin-antiseptics. They rarely cause irritation and leave the hair feeling very silky. Care must be taken however to avoid contact with the eyes.

Contrary to popular opinion baby shampoos are not necessarily milder or more gentle in their cleaning action than other shampoos. The major difference is that they have to conform to a number of legal requirements in most countries. Babies have a far larger skin area in relation to bodyweight than adults so these shampoos may not contain any ingredients which could cause harm if absorbed by the skin. The other major requirement is that they may not cause damage to the conjunctive membrane of the baby’s eye.

Many of the shampoos available today are marketed as being P.H. balanced. Some companies make this a particular selling point for their products. The term P.H. refers to percentage of hydrogen which is used on a scale of 1-14. Acid solutions are from 1-7, 7 is neutral and alkaline solutions are 7-14. Normal skin is slightly acid having a P.H. value of about P.H. 5.4-5.6.

Permanent waving lotions and straightening creams have a P.H. value of up to 9.6 which his very alkaline. Products stronger than this are illegal in many countries as they are likely to cause skin irritation and chemical burning. Alkalies cause the hair to swell and loosen the cuticle cells. Acidic compounds have the opposite effect but if too strong the hair will become hydrolysed and made more brittle and less elastic with the consequent likelihood of breakage.

Conditioners are usually slightly more acidic than shampoos to counter the effects of hairdressing chemicals. In most cases however the scalp will return to its normal slightly acid level within a half hour but the hair can be greatly affected for good or ill.

Do you have Hair Loss Problems, read our Hair Loss Help

Hair Colouring. Does and Don't.

There are an infinite variety of hair colourant products available and the choice of which to use can be highly confusing. In many countries product labels are not very clear on the type of colourant that they contain.

There are five major categories of hair colour and it is vital to check upon which is which before using them.

The most simple of these are:

Water Soluble Rinses are applied to the hair after shampooing and conditioning and may come in either mousse or liquid form. These colours are left on and the hair dried as normal. They are water soluble inks which coat the hair surface. They are easily removable and need to be replaced each time the hair is shampooed. Unfortunately they can leave stains on towels and pillowcases.

The effect of water rinses is limited and serve only to slightly alter the colour and tone of the hair which is why they are sometimes referred to as toning rinses. Allergy to these products are extremely rare so generally they are harmless but don’t get caught in the rain!

Semi-Permanent Colours are stains which are usually shampooed into the hair, left on for a time and the excess rinsed off. Hairdressers often refer to them as herbal although they are the result of highly technical pigment laboratories.

Semi-permanent colours may tone down up to about 20% grey hair, give a warmer colour to mousy hair. Under normal conditions they gradually wear off after about four to six shampoos but may gradually build up with regular use. One point of interest is that they stain the outer layer or cuticle of the hair which normally contains no pigment. Because the added colour is left on the surface of the hair, the hair often appears brighter and more shiny which is why they are often referred to by hairdressers as colour ‘conditioners’. Some of them do also contain hair conditioning agents but not all.

These colourants are usually harmless and only rarely cause irritation or sensitivity. On the negative side they are often messy to apply, plastic gloves should be worn to prevent staining of the hands. If using them at home use an old or very dark towel as they can be very slow to wash out of fabrics.

Herbal Colours. Some years ago a long series of experiments were carried out using small hair swathes and volunteers to test every known herbal colour. When used on white hair they had not visual effect except for logwood (brown) and madder (purple-red) which frequently caused scalp irritation and scaling when used in the concentrations required.

Very concentrated solutions of various types of Chamomile were tried on ash blond hair as this was claimed to improve hair colour. Even after an hours immersion before drying, professional tinters could not tell the difference. Diluted lemon juice can sometimes cause the hair to look slightly more red. Strong or concentrated lemon juice will leave hair brittle due to its acidity and will lighten in combination with sunlight, a popular method in renaissance Italy.

Of all the herbal colours tested only HENNA made any worthwhile difference. Dried henna comes from the roots and leaves of the plant Hennara Lawsonis. Its active principle, Lawsone, is a resinous substance which has a strong affinity for hair proteins. Contrary to most uninformed opinion, henna is NOT good for hair and if used too frequently can cause dryness, dehydration and breaking. In herbal medicine henna is known as one of the most powerful astringents. It can only be removed gradually by using oils on the hair which act as solvents for the lawsone. Hair treated with henna should not be permanently waved as the absorption time of the perming lotion is increased so that processing takes longer and excessive chemical damage is caused to the hair.

If used four or five times a year, henna is unlikely to damage healthy hair and it is suggested that it is not used more often.

To create variations in shade, henna from different countries may be used.

Indian henna is deep red, Spanish henna is bright red and South American henna is aubergine in colour. Added lemon juice increases redness. Coffee, black walnut husks or even tealeaves will help to tone down the redness slightly. Obviously the final result depends on the natural base colour of the hair. On very dark hair the colour is only slightly warmer. On white hair a very unattractive orange colour is produced. Henna, like semi-permanent colours, stains the hair cuticle and although the hair may appear shinier, it does not have a conditioning action and is of no benefit to the health or texture of the hair, only the colour. There is also a system of hair colouring called Progressive Dyeing in which clear solutions of metallic salts are applied to the hair on a daily basis. These salts gradually absorb oxygen from the air causing chemical changes which produce a dark stain on the hair. Originally lead, bismuth, antimony, iron and silver. Many of these are toxic. Iron and silver salts are still occasionally used but because they react violently with modern permanent waving and tinting chemicals, and their use is not recommended.

Tinting and Bleaching. Tints and bleaches are the only colourant chemicals which react with the cortex or main body of the hair and must be used with very great care to avoid serious damage.

Tints are oxidising colours using para dyes, that is either Paratoluene Diamine or Paraphenylene Diamine. They are only activated in the presence of an oxidising agent usually a solution of hydrogen peroxide. These must be mixed together immediately before use and once mixed cannot be kept for future use.

Generally, if tinting hair lighter than the natural colour either a greater volume or more concentrated solutions of hydrogen peroxide are used. If tinting darker and to cover grey hair, either less peroxide or a lower volume of peroxide may be used. Peroxide strength is measured in volume of available oxygen dissolved in each centilitre of water in the peroxide solution.

The benefits of tinting are that complete coverage of grey hair is possible and that a great choice of colour is available either lighter, darker, warmer or more ash than the original colour.

Tints may fade but do not wash out. On the minus side they do leave hair dryer and more porous. The roots need to be re-tinted regularly as the hair grows, showing its natural colour. Ideally re-tinting should be done without overlapping already tinted hair to minimise the drying effect. Tints do fade more rapidly than natural hair in sunlight and as they are composed of a number of different pigments these do not fade at the same rate. By darkening grey or white hair, the colour may look too hard and not suit skin tones.

There is also a small but significant risk of developing an acute allergic reaction so it is sensible to do a small patch test by mixing a tiny quantity of tint with peroxide and applying it to the skin, either behind the ear or inside the elbow. Leave it on for thirty minutes before rinsing off thoroughly. The area should be examined after 48 hours and if any itching or redness, soreness or acute inflammation occurs DO NOT USE TINT ON YOUR HAIR EVER AGAIN. If nothing happen, and this is usual, it is safe to tint your hair. Ideally it is a good thing to do before every tint, although it may be a nuisance and the risk is admittedly small. Allergies may develop at any time and just because you may have been tinting your hair for many years is no insurance.

Bleaching. As the name suggests, involves using a bleaching powder usually alkaline mixed with hydrogen peroxide to oxidise the hair and remove part or all of its natural pigment. It is important to remember that dark hair is made up of red and yellow pigments and that simple bleaching can leave the hair carrot coloured or very yellow, depending upon the degree of lightening. If hair is bleached white, its structure will almost certainly be destroyed and will break off.

Changes in hair colour should never be too drastic as the greater the colour change, the greater the damage caused to the hair fibres and its elasticity will be severely reduced. Cosmetically the hair may not match the natural skin tones of the face and this can look very unflattering to the appearance. Fifty year olds can find that if they continue to tint their hair to its original dark colour this is too hard for the skin tones giving a very ‘washed out’ look. Hair that is strongly bleached tends to look very flat and uninteresting.

Highlighting and Lowlighting. Is the process in which fine streaks of hair are taken and either bleached or tinted. If carried out by experts, highlights can be used around the face to give softness and two or three different shades of tint can be used to add movement and interest to the hairstyle. Grey hair can also be disguised without being completely covered over. Due to the fact that only a portion of the hair is processed, any damaging or drying effects are greatly minimised, the colours are softer and more natural.

All of the chemicals used for bleaching or tinting hair are capable of causing damage and unless you are skilled at managing your own hair, it is a lot safer to go to a competent professional hairdresser or tinter. Although the chemicals used for ‘home’ perms and ‘home’ tints are slightly slower versions of the professional’s products, it must be emphasised that they are still dangerous chemicals which is why it is safer to leave these processes to professionals.

Do you have Hair Loss Problems, read our Hair Loss Help